What Is A Relapse Prevention Plan

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KEY TAKEAWAYS

A relapse prevention plan is a plan created between an individual and an assigned keyworker, to prevent potential relapses from occurring, once in-patient treatment concludes.

It contains:

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What A Relapse Prevention Plan Does

The intended outcome of a relapse prevention plan is to avoid emotional relapse, mental relapse and physical relapse when leaving rehab by considering in detail what may cause relapse to occur, including:

  • Triggers - people, places and times of the year can all be reminders of drinking and lead to relapse
  • Cravings - particularly if alcohol abuse was severe
  • Lifestyle - relapse prevention plans will work towards amending relationships and financial issues that may later result in relapse

A relapse prevention plan provides the tools to avoid falling back into old habits that cause relapse by having support systems in place to deal with triggers.

When Is A Relapse Prevention Plan Essential?

A relapse prevention plan is considered essential under high risk of:

  • Re-occurring relapses - 20% of patients remain sober in the first year after treatment, increasing to 40% after 2 years [2]
  • Isolating from others - either not having or not utilising support systems
  • High-risk situations - being exposed to enablers, environmental factors and triggers that previously caused addiction
  • Anxiety and depression
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A relapse prevention plan is considered beneficial, but not essential, under:

  • Poor self-care - such as sleep, personal hygiene and diet
  • Lack of experience in using coping strategies
  • Fear of relapse - particularly if previously have avoided treatment due to fear of withdrawal symptoms

When To Use A Relapse Prevention Plan

Relapse prevention plans are normally part of an overall treatment plan in inpatient or outpatient rehab facilities.

Using a relapse prevention plan after rehab helps identify the underlying causes of alcoholism and raise awareness of how behaviour needs to change, unlike implementing a relapse prevention plan on those who have only detoxed the physical addiction [3].

When NOT To Use A Relapse Prevention Plan

Circumstances or conditions where a relapse prevention plan may not be useful include:

  • Those with social anxiety - specifically for elements of relapse prevention plans involving group relapse prevention therapy
  • Those who have physically recovered from alcoholism (detoxed) but are either in denial about ongoing habits, or are not accepting responsibility for addiction, and therefore will not follow a relapse prevention plan, even if provided for them.
  • Those who have enabling friends or family members that continue to encourage alcoholism after treatment, meaning that risk of relapse remains high, even with a highly structured plan in place [4].

Relapse Prevention Plan Structure

Identifying Personal Goals

A relapse prevention plan allows the alcoholic to focus on reasons to maintain sobriety, with manageable goals such as:

  • Career goals
  • Making amends for behaviour during addiction
  • Improving relationships with family and friends

Personal goals are useful for the alcoholic to refer back to, particularly when struggling with changing lifestyles or contemplating relapse.

The personal reasons for wanting to achieve sobriety, to motivate further success in recovery.

Identifying Triggers

Each alcoholic will have triggers that specifically affect them, so a treatment plan needs to identify those triggers in order to put coping mechanisms in place to avoid relapse.

In a residential treatment setting, the input for this can come from learnings gained during the therapy process.

Identifying Methods To Minimise Triggers

Methods must be successful in minimising the alcoholics' specific triggers, including:

  • Avoiding places where drinking previously occurred and people who encourage drinking
  • Attending 12-step meetings and seeking support from others in recovery
  • Calling a designated support system when considering drinking

Preventative Tools

An effective relapse prevention plan will incorporate ways to avoid relapse and continue through recovery, including:

  • Seeking professional support - such as cognitive behavioural therapy and alcoholics anonymous
  • Creating positive habits - such as exercising and journaling
  • Writing a list of consequences if relapse should occur

Support System

Outlining positive support systems, such as family, friends, mentors, treatment providers or members of support groups [5].

Know The Warning Signs

Consider what the specific warning signs of nearing a relapse are.

Share these signs with the wider support group, to look out for.

Prepare For Relapse

A relapse prevention plan will include what to do post-relapse, such as speaking to a member of the support system, attending further outpatient support groups, or going back into an inpatient rehab facility.

Time To Self Reflect

Taking time to consider current emotions as well as how emotions lead to previous addiction and relapse.

Self Care

Relapse prevention relies on utilising self-care, such as relaxation techniques, exercise, a healthy diet and good sleep.

Resolving Issues Caused By Addiction

Alcohol abuse may cause relationship, financial and legal issues that contribute to relapse; making a plan to resolve them assists in preventing relapse [6].

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Relapse Prevention Plan vs The Alternatives (Success Rates)

40-80% of patients experience a lapse with a relapse prevention plan in the first year of sobriety, but only 20% return to pre-existing levels of alcoholism [7].

Out of 20 studies, 64% of those with a relapse prevention plan achieved sobriety, unlike 33% of those without a relapse prevention plan.

Customising A Relapse Prevention Plan

An effective relapse prevention plan considers the individual's history of addiction, including past triggers, as well as reasons for addiction and relapse when customising a plan.

If the patient has completed an outpatient detox or treatment programme, they may need to incorporate dealing with underlying issues causing alcoholism in relapse prevention therapy that have not been addressed during detox.

Older adults need to take into account the higher potential for grief, depression and social isolation when customising a plan, making sure to include support groups and sponsors [8].

Women are one-third less likely to relapse during treatment than men, meaning men's treatment plans should focus more on the potential of relapse [9].

A relapse prevention plan should assess how mental and physical health problems worsen or influence alcohol use and influence likely relapse rates [10].

Benefits Of RPP To Others

A relapse prevention plan is beneficial to others such as friends, family members and other healthcare providers to understand the individuals' warning signs, triggers and personal goals to assist in preventing relapse.

Having a relapse prevention plan in place may be beneficial for potential employers or during legal situations as it demonstrates taking responsibility for addiction and a willingness to maintain sobriety moving forward.

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Aftercare Plan vs Relapse Prevention Plan

An aftercare plan discusses the steps that an individual takes after rehab, such as group therapy, 12-step meetings or self-care.

A relapse prevention plan is similar, but also considers the specific causes of relapse and gives responsibility to the patient so they can understand triggers, develop healthy coping skills and maintain sobriety with longevity.

Relapse prevention plans are more appropriate when the patient has experienced relapse previously, they are returning to an environment with lots of triggers, or are at increased risk of emotional relapse due to co-occurring mental health conditions.

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About the author

Harriet Garfoot

Harriet Garfoot BA, MA has an Undergraduate degree in Education Studies and English, and a Master's degree in English Literature, from Bishop Grosseteste University. Harriet writes on stress & mental health, and is a member of the Burney Society. Content reviewed by Laura Morris (Clinical Lead).

Last Updated: November 6, 2023